High-risk pools off to slow start

A handful of states that have begun accepting applications for their new federally funded high-risk health insurance pools have seen a slow trickle of enrollees but expect a bigger wave as word spreads about the option.

Representatives of these pools in Colorado, New Hampshire, New Mexico and North Carolina told POLITICO that while they are generally pleased with the enrollment process so far, they still harbor some concerns about outreach and affordability. Their offices have experienced a higher volume of calls and website traffic since the launch and hope the inquiries about the new program will soon translate into applications.

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Michael Keough, executive director of the North Carolina Health Insurance Risk Pool, suggested that one factor contributing to the relatively low enrollment was the Fourth of July weekend.

“Holiday weekends are typically slow periods, even with the kickoff we had in the media and elsewhere,” Keough said. North Carolina began accepting applications on July 1.

These states are the front-runners among 29 states and the District of Columbia that have opted to administer their own high-risk pools with federal subsidies under the Patient Protection and Affordable Care Act.

Many of the largest states operating their own high-risk pools, including California and New York, will not begin enrollment until August. Some of these self-administering states will run the new federal option in conjunction with existing state options.

Congress allocated $5 billion to run these temporary pools until 2014, when insurers will be barred from denying coverage to individuals based on pre-existing conditions.

To be eligible, individuals with pre-existing conditions must have been uninsured for at least six months and demonstrate that they have been denied coverage elsewhere.

The federal program offers a more affordable option for coverage than existing state high-risk pools — for example, Colorado’s premium rate is 131 percent of the average market rate and North Carolina’s is 150 percent of the standard risk rate.

Since launching the program, states have reported a mixed bag of responses from enrollees, ranging from those who are “overjoyed because they can at last afford coverage” to those who remain frustrated that they still cannot afford it, according to Keough.

Meanwhile, those already enrolled in the state programs who want to switch to the new, less expensive federal option would have to be uninsured for six months to become eligiblefor the federal program. “It’s a tough situation. If you can save a third a month, which is a significant decrease, the question is if you can afford to pay your bills for six months,” said Keough. Lorez Meinhold, director of health reform implementation in Colorado, acknowledged that the new federal option still remains unaffordable for some individuals. “This is not necessarily for low-income people but a resource for folks who have needs but can afford the $5,950 out of pocket. ... The high-risk pool wasn’t meant to solve all of the issues.”

Meinhold added that the state government, in conjunction with the existing state pool CoverColorado and Rocky Mountain Health Plans, is pursuing health care reform in “bigger and broader ways.”